The Medical Council’s new ethical guide has tackled the controversial issue of healthcare resources head on by openly encouraging doctors to prescribe generic drugs.
In a major departure for the Council, the seventh edition of the ‘Guide to Professional Conduct and Ethics for Registered Medical Practitioners’, states that doctors have a ‘duty’ to assist in the efficient and effective use of healthcare resources and to give advice on their appropriate allocation.
“While balancing a duty of care to the individual patient, you should be aware of the wider need to use limited healthcare resources efficiently and responsibly. Such awareness should inform decision making in your clinical practice,” the guide states in Paragraph 49.
Specifically, it informs doctors that they are encouraged to prescribe ‘bio-equivalent generic medicines where they are safe and effective and only commission investigations if they are clinically indicated’.
In its previous guide published in 2004, the Council said doctors had a ‘place’ in helping to ensure the efficient and effective use of resources, but that in exercising indicative drugs budgeting they should be ‘principally concerned with the patient’s best interests’.
Published on the Council’s website, the extended guide runs to more than 60 pages and clarifies a number of matters for doctors and their patients, including issues of consent, confidentiality, end-of-life care, the provision of information to the public, prescribing practices and referral of patients.
However, it has avoided addressing a number of thorny issues, such as assisted human reproduction and stem cell therapy. President Prof Kieran Murphy said the Council was ‘exercised’ by the lack of legislation in this area, and thus was unable to take a position.
“We hope over the term of the remainder of the Council to develop further comprehensive guidelines based on assisted human reproduction,” he stated.
The Council also intends to address the relationship between doctors and commercial enterprises in future guidelines.
While no direct reference is made to stem cells, the guide states that doctors should not participate in ‘creating new forms of life solely for experimental purposes’.
On the controversial subject of abortion, it retains the wording that terminations are illegal except where there is a ‘real and substantial risk’ to the life of the mother.
However, the Council has inserted a clause stating that this exception includes where there is a ‘clear and substantial risk to the life of the mother arising from a threat of suicide’, thus bring the guide into line with the legal position arising from the ‘X’ case.
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